Comparative analysis of the methods of an all-endoscopic brachial plexus decompression and a mini-invasive endoscopically-assisted technique for management of patients with traumatic brachioplexopathy

Abstract

Introduction As reported, brachioplexopathy is a relevant polyetiological disease with an annual incidence from 0.17 to 1.6 per 100,000. There are two basic endoscopic methods of brachial plexus decompression: an  endoscopically-assisted mini-invasive transaxillary approach and fully endoscopic decompression in association with shoulder arthroscopy.Purpose Compare the two main endoscopic methods of brachial plexus decompression.Material and methods Twenty-two patients diagnosed with post-traumatic brachioplexopathy were included in the study. There were 8 patients in group 1 and 14 patients in group 2. All patients passed clinical and instrumental examination. Statistical analysis was performed with non-parametric U-criteria of  Mann – Whitney. Differences were considered significant at p < 0.05. Patients of group 1 underwent shoulder joint arthroscopy and fully endoscopic brachial plexus decompression. Patients of group 2 had revision and transaxillary mini-invasive decompression of brachial plexus with video endoscopic assistance.Results In the first group, upper limb dysfunction according to DASH scale decreased from 52.3 ± 2.2 to 28.8 ± 3.8 points (p < 0.05). In the second group, upper limb dysfunction according to DASH scale decreased from 47.9 ± 4.4 to 26.6 ± 4.3 points (p < 0.05). Discrepancy according to DASH scale before and after surgery in the first group was 23.5 ± 3.6 points and in the second group it was 19.4 ± 5.4 points; the difference between the groups was statistically insignificant (p > 0.05).Discussion The results of our study are similar to the results of endoscopic brachial plexus decompression in the previously published studies.Conclusion The methods of endoscopic brachial plexus decompression in association with shoulder joint arthroscopy and isoolated mini-invasive neurolysis and decompression of brachial plexus under videoendoscopic assistance are equally effective in the treatment of brachialplexopathy.